A case of malignant melanoma (amelanotic type) of upper gum.

概要

論文の詳細を見る
Malignant melanoma will be rarely found in the oral cavity, and the disease seemed to be easily diagnosed because of the characteristic pigmentation. On the other hand, there are some difficult cases of the amelanotic type to make a differential diagnosis from other neoplasma correctly because of their rare occurrence and lack of pigmentation. Therefore, these tumors are apt to be easily resected without confirmation when diagnosis was made by clinical findings alone. According to these reasons, it is generally accepted that the prognosis of amelanotic type of malignant melanoma is rather poor, compared with the melanotic type of malignant melanoma. A male patient, 67 years old, was found to have a bumpy nodule in his upper gum 6 months ago, prior to his first hospital.visit. The nodule increased gradually, and showed some bleeding tendency during tooth brushing. He was examined by a dentist and the nodule was immediately resected without precise diagnosis. Within 2 months after surgery, however, the tumor reappeared. Physical examination revealed that the nodule was 15×12mm in size, pinkish color and peduncolated, which was shown by the partial errosion in the tumor. The tumor was characterized by elastic soft consistency and revealed a bleeding tendency, but had neither ulcer nor pigmentation at all. The X-ray examination revealed that pathological resorption of alveolar bony structure was absent. The palpated regional lymph nodes were within normal limits. Since the surgical excision of a wide tumor area has been performed, he has been followed up carefully and periodically in our out-patient clinic. Six months later, although no changes were recognized in the primary site, the left submandibular lymph nodes were observed to grow gradually. He was suspected to have metastasis of the lymph nodes in the submandibular region, which were not extended to other distant body parts. This was confirmed by the whole body scintigraphy, using 67Ga and 99mTc. A radical neck dissection was performed and there were a lot of metastases, whose histopathological analysis have demonstrated the affected regional lymph nodes. After the surgical procedure, he received adjuvant immunochemotherapy. The protocols of combined chemotherapy were as follows:(1) OK-432, 5.0 KE twice a week, (2) Pepleomycin 10mg, ACNU 100mg and VCR 1mg weekly and (3) DTIC 100mg, ACNU 100mg and VCR 1mg weekly. The protocols of (2) and (3) have been applied on the patient for 1 week of medication time, which did have 3 weeks of pausing duration in-between. This procedure of (2) has been repeated 3 times and that of (3) has been repeated 2 times during the hospital course. That of (1) has been applied every 3 days. After all procedures were finished, he was discharged without finding of recurrence or metastasis of tumor. However, 6 months later on a regular check-up, an X-ray examination of the chest revealed a suspicious shadow of metastasis and recurrence was found at the left cervical. Immediately, radiotherapy was performed and the tumor was regressed but another metastasis appeared in the chest and increased in both size and number and then he died of pneumonitis.
社団法人日本口腔外科学会の論文

A case of malignant melanoma (amelanotic type) of upper gum.

スポンサーリンク

概要

著者

関連論文

スポンサーリンク